A study, with some limitations, sees link between youth football and emotional issues in adulthood

outh football participation in the U.S. has dropped in recent years as parents have grown more concerned about concussions. A new study could accelerate that trend.

The research, by noted brain trauma scientists, found that those who play youth tackle football before age 12 are more likely to suffer from depression, apathy, and other behavioral issues later in life.

The study has “tons of limitations,” said Robert Stern, one of the authors, and the data are not strong enough to suggest that football was the cause of behavioral abnormalities. But Stern said the findings provide further reason to question whether younger children should be playing tackle football — beyond research that has linked repetitive head blows and concussions to brain damage.

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“When do we ask ourselves, ‘Does it make sense for my kid to be hitting his head several hundred times per season?’” Stern said.

The study, which appears in the current issue of Nature’s Translational Psychiatry, included 214 men; about half started playing football before age 12 and the rest at 12 or older. Forty-three of them played through high school and 103 played through college. The remainder played professionally.

The men were, on average, 51 years old at the time of the study. Those who started playing when younger demonstrated a twofold increase in risk for apathy and behavioral regulation and a threefold increase in risk for depression, compared with those who started playing later.

Significantly, men who went on to play in college or the pros were no more likely to have these problems than those who stopped playing after youth football.

Stern, the director of clinical research at Boston University’s CTE Center, said study participants were interviewed by phone and completed online questionnaires, a methodology that is not as reliable as face-to-face neuropsychological examinations.

More important, the participants chose to take part in the study, rather than being chosen at random, so they may have had neurological deficits that spurred their involvement in the research.

Other researchers pointed out this flaw as well, but said the study nonetheless warrants further investigation, if not stricter limits on youth participation in America’s most popular sport.

Tom Talavage, a professor of biomechanics at Purdue University who studies neurotrauma, said: “I’m not the least bit surprised by this.

“Intuitively, it’s pretty consistent with our impression of the old former football player — that he’s a little more volatile, a little more impulsive, maybe a little more moody.”

The findings are also consistent, he said, with his own recent research on middle-school football players that shows that even though younger children hit each other with less force than older ones, “because they’re smaller they’re getting essentially the same ‘experience,’ quote-unquote, as the high-school population.”

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The researchers chose 12 as the age cutoff because, they said, the brain experiences a key period of development between 10 and 12. They also tracked changes in behavior for those who began playing at earlier and later ages, but said age 12 was associated with the most striking findings.

Another study published last year by researchers at Wake Forest School of Medicine involved MRI scans of middle-school football players’ brains; it showed changes related to non-concussive head impacts after a single season. (The research, which relied on a relatively small sample, did not examine a possible relationship between the brain changes and cognitive function.)

Joel Stitzel, one of the leaders of that research, said the new study is “important and informative,” and “helps motivate the need for more longitudinal study.”

Stitzel also noted that retrospective research like Stern’s fails to account for more recent rule changes in youth football, including limits on full-contact practices and more aggressive coaching on proper tackling techniques.

Pop Warner Little Scholars, which oversees what it describes as the nation’s oldest and most popular youth football, did not immediately return calls requesting comment, and Dr. Julian Bailes, the youth league’s medical director, was unavailable.

Both Pop Warner and USA Football, another youth organization, have implemented or tested significant rules changes in recent seasons.

Dara Dickstein, who researches neurodegenerative disease at the Icahn School of Medicine at Mount Sinai, acknowledged the “game has changed a lot” over time.

Still, she said, “it doesn’t really surprise me that the younger your age of first exposure is to football, the more impairment or cognitive deficits will show later in life.”

Despite safety concerns, proponents of youth football have pointed out the sport’s benefits, noting that, beyond the physical exercise, it instills a sense of teamwork, discipline, and camaraderie among players.

Stern has heard the arguments before.

The solution to this is not to have kids in a bubble, and have them not exercise,” he said. “Comaraderie, teamwork, confidence building, exercise — those things are really important. But playing tackle football is not the only way to get that.”

The study was funded by the National Institutes of Health. Some of the 21 co-authors disclosed possible conflicts of interest, including research funding and their work with the National Collegiate Athletic Association, National Football League, and NFL Players’ Association. Stern, for instance, is a member of the Mackey-White Committee of the NFL Players Association and is a paid consultant to pharmaceutical companies. Dr. Ann McKee has received funding from the NFL and is a member of the Mackey-White Committee. Dr. Robert Cantu is a paid consultant to the NFL’s Head Neck and Spine Committee and is a paid member of the Medical Science Committee for the NCAA Student-Athlete Concussion Injury Litigation.

This is one of the flimsiest “studies” I have ever seen… there is NOTHING that supports this headline….

Another article says

“And they had undergone a variety of cognitive tests on telephone interviews, and they filled out these questionnaires about depression and behavior and apathy, things like that, on the web. ”

Cognitive test via telephone and questionnaire via the web? And this “doctor” came to a conclusion that the brain sustained physical damage (without concussions) due to Football, and that caused/causes behavior problems….yet this “doctor” never met, examined or had any kind of physical tests done on the “subjects” who answered questions?

Just curious – what is the research on kids who play other sports since young? I’m wondering if this finding can be attributed specifically to those kids with brain insults early on, or to all kids who play sports since young? For example, how much of depression and behavioral problems is due to kids who start early then fazed out feeling like they didn’t ‘make it!?

My 10-year-old son is in his first season of youth football in a USA Football league. His mom and I were worried about concussions and other injuries and still are, but we still support and encourage our son’s decision. For now.

I probably had a layperson’s beliefs about the connections between tackle football and brain injury. But one thing I’ve noticed after watching 10-year-olds practice and play is that there is a big difference between children who play football and those who succeed at it.

From what I’ve seen, the kids who are at highest risk are those who are most responsive to the coaches’ exhortations to play more aggressively and athletic enough to do so. On my son’s team (and on the teams I’ve seen him play against), that number is very small. The greater number of boys are shy of violence and somewhat befuddled by the dynamism of the game; they sort of mill around and bump into each other (slowly) on snaps, apparently trying to remember what they’re supposed to be doing. Any kid with slightly better than average speed and field sense can and does run rings around them without too much resistance.

Mediocrity shields most of the boys from the perils of the game.

I’d guess that this mediocrity is persistent as the kids move up the ranks to older-age teams. It must continually winnow out the low-risk boys (the worse athletes) until, by college and pros, the only players left are those who’ve demonstrated the aggression and athleticism that exposes them to the most violent hits. I’m trying to say I’m not surprised to see so much CTE and every other kind of injury in the pros and possibly the elite college levels: those are the only players capable of inflicting that kind of damage, of propelling themselves at 20 or so miles an hour into an opponent.

Back down on the kids’ level, what I’ve seen makes that look like a remote possibility for most of these boys (a couple of girls too). They just don’t have the killer instinct (or testosterone yet!) or athletic skill to deploy it. Accidents can happen of course, but from what I see, I believe there’s a correlation that hasn’t been teased out between the talent of the player (athleticism and aggression) and the likelihood of injury. Most of the kids playing the game just aren’t that good. Or that tough.

I grew up in a neighborhood that played multi-age, co-ed flag football, at a time children ran free in neighborhoods. It was fun, and concussion-free.

One wonders if caution regarding interpretation of medical research – instead of the precautionary principle and common sense – is killing, harming and/or dementing us slowly. Is it that hard to believe that repeated trauma to the brain might not be best for its healthy development, long term? The benefits may outweigh the risks for some, and the reverse for others. For children especially, why not make football safer, and fun.